The nature of the injury to the bladder depends on how full the bladder was at the time of injury and what caused the injury.

Traumatic injury to the bladder is uncommon. Only about 8 - 10% of pelvic fractures are associated with bladder injury. Because the bladder is located within the bony structures of the pelvis, it is protected from most outside forces. Injury may occur if there is a blow to the pelvis that is severe enough to break the bones and cause bone fragments to penetrate the bladder wall.

An examination of the genitals may show injury to the urethra. If the health care provider suspects an injury, a retrograde urethrogram should be done to show the structure of the lower urinary tract.

Examination may also show:

Bladder injury or swollen (distended) bladder

If the bladder lining has been disturbed, urine may escape from the bladder into the abdominal cavity.

Other signs of pelvic injury, such as brusing over the penis, scrotum, and perineum

Signs of hemorrhage or shock, including decreased blood pressure -- especially in cases of pelvic fracture

Tenderness and bladder fullness when touched (caused by urine retention)

Tender and unstable pelvic bones

A Foley catheter (a tube that drains urine from the body) may be inserted.

Treatment:

The goals of treatment are to:

Control symptoms

Repair the injury

Prevent complications

Emergency treatment of bleeding or shock may include:

Blood transfusions

Intravenous (IV) fluids

Monitoring in the hospital

Treatment of peritonitis may include emergency surgery to repair the injury and drain the urine from the abdominal cavity. Antibiotics may be given to treat peritonitis and to prevent urinary tract infections.

Surgical repair of the injury is usually successful. The bladder may be drained by a catheter through the urethra or the abdominal wall over a period of days to weeks. This will prevent urine from building up in the bladder, allowing the injured bladder or urethra to heal. This also prevents swelling in the urethra from blocking urine flow.

If the urethra has been cut, a urological specialist can place a Foley catheter. If this cannot be done, a tube will be inserted through the abdominal wall and directly into the bladder. This is called a suprapubic tube. It will be left in place until swelling goes away and the urethra can be surgically repaired. This typically takes 3 - 6 months.

Support Groups:

Expectations (prognosis):

Traumatic injury of the bladder and the urethra may range from minor to major and life-threatening. There may be severe, immediate, or long-term complications.

Go to the emergency room or call the local emergency number (such as 911), if you have symptoms of traumatic injury of the bladder or urethra -- particularly if there is a history of injury to the area.